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Gout Symptoms, Causes, Treatment
Blog January 19, 2025

Gout Symptoms, Causes, Treatment

Dr. Yeonseung Choe
Dr. Yeonseung Choe
Chief Director
Gouty arthritis, characterized by gout attacks accompanied by extreme pain, is one of the primary reasons people visit hospitals more frequently than for general musculoskeletal pain.

Causes and Mechanism of Gout

Gout occurs when uric acid (uric acid), a metabolite of purine, is not properly excreted, primarily forming crystals in the joints that trigger inflammation and manifest as extreme pain. The onset of extreme pain due to gout is called a gout attack (gout attack), which often subsides and then recurs.

Inflammation Progression Pathway

Looking at the inflammation progression pathway in gout, when uric acid crystals called MSU crystal stimulate macrophages, the IL-1 pathway is activated, triggering an inflammatory response. This reaction can be heightened by uric acid in a non-crystallized state, meaning acute gout attacks can occur in a state of hyperuricemia even if crystals are not visible.

Autoinflammatory Diseases and Immune Response

Recently, the term autoinflammatory disease is used as a counterpart to autoimmunity, with focus being placed on the mechanism of gout. It is expected that this can be applied to more effective treatments based on an understanding of immunity and inflammation.

Gout Treatment Guidelines

The following medications are used in the treatment of gout:

  • NSAIDs: The most commonly used anti-inflammatory analgesics
  • Colchicine: Used as an inflammasome inhibitor
  • Glucocorticoids: Utilized as steroids

Korean Medicine Treatment and Alternative Therapies

In Korean medicine clinics, treatment is carried out from the perspective of "removing wind-damp-heat" based on the concept of damp-heat in the joints. The focus is on controlling pain and recovering from inflammatory responses through acupuncture and herbal medicine, and it also includes strategies to facilitate excretion through urine and stool to prevent uric acid accumulation.

Dietary Therapy

Dietary therapy is significantly important in the management of gout. Foods that are good for gout will be covered in detail in another post.

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Dr. Yeonseung Choe

Dr. Yeonseung Choe Chief Director

I have met many patients who came after visiting multiple medical institutions and departments for persistent or recurrent conditions. Symptoms normally handled by different specialties—such as abdominal pain, headaches, palpitations, dizziness, and insomnia—may overlap in one person. Sometimes there is no clear improvement despite taking medication for each symptom, and being unwell gradually becomes part of daily life. In these cases, I look beyond individual diagnoses and examine how the symptoms connect and change together. Asking only about the most uncomfortable symptom today does not reveal the full course. I look at when the body first began to change and what happened after illness, surgery, childbirth, or starting and stopping medication. I also review changes in weight, diet, and sleep, then trace which symptoms improved with previous treatment and which remained. Test results, diagnoses, and the course of previous treatment are important for understanding the current condition. Clinical research in modern Korean medicine, physiological and pathological research in modern medicine, and observations recorded in classical Korean medicine texts offer different perspectives on the same body. Rather than fitting a patient into one perspective, I consider what each can and cannot explain and look for clues that connect symptoms and treatment histories that were previously considered separately.

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